Give in to IBS or more tests ?
I have had a life long history of digestive troubles. Lower abdominal pain about 20 min after eating, cramps, pressure, usually followed by one or more bowel movements. Usually the first one is firm and fine, and then they get progressively looser and less formed. By number 5 or 6 (when there is nothing left), they look like coffee grounds.
I have traveled and lived in foreign countries a lot. I have a high stress job and the condition has always been aggravated by travel and stressful situations. I have had an endoscopic exam (years ago) and a colonoscopy about 2 years ago - they found a single benign polyp and some internal hemorrhoids (I was experiencing blood on the paper and stool). The doc said eat a higher fiber diet and don't strain.
The blood stopped, and the other symptoms went into remission for a good while (2 years). Now the cramps and multiple bowel movements have come back - usually at work about 20 min after lunch. Occasionally on weekends or at night, though usually just after lunch at work. I went to the doc and he listened to all of this and said IBS right away - no tests. He put me on Levsin 2 x a day.
That seemed to help the cramps for about 2 weeks but lately, through the holidays it has been getting worse - more frequent and more painful. My bowel movements are frequent and unformed. Sometimes it looks like bits of undigested food in there and sometimes it is even orangish in color, or with clear mucous. The cramps start almost immediately after I eat.
I eat a pretty healthy diet - lots of fruit and veggies, fish, high grain cereals. I hardly ever eat fast food. I do like to eat unusual foods, but not what I would consider unhealthy - sushi, octopus, Spanish dishes - sometimes a bit spicy. I also drink alcohol on a daily basis - probably a bit more than I should - maybe 3 beers or a few glasses of red wine. I don't drink coffee - tears me up, but I do have one cup of tea in the morning.
Some details -
I have had food poisoning on more than one occasion - one rather nasty bout from bad seafood in Europe in late October - they injected me with antibiotics and gave me Cipro. Also, I have lost about 15 lbs since June of 2001. The doc did blood work for liver and thyroid - all normal. Weight loss has stabilized but remains a mystery. I went from 163 to 148. I run 7 to 10 miles a week, work out 2 or 3 times a week, and am generally active. I have been doing this for years so the amount of physical activity has not changed. I am a white male, 41 years old.
So my question is should I just assume that this is IBS and right now I am in a "down phase" that will hopefully pass or should I take a more aggressive stance and ask for another colonoscopy, or tests for bacteria or parasites ? Lately this has really had me down, pretty much ruined the holidays, and been a general big pain in the butt (pun intended), embarrassing at work etc. Any comments are appreciated.